QPR Newsletter

As QPR Instructors you may be asked by those in your audiences about the new FDA recommended warning label to be placed on antidepressant medications, especially as regards the supposed link between taking the medication and increased suicidal thoughts, feelings and behaviors. While you may have your own thoughts about what this announcement means, Dr. Quinnett responded with the following Letter to the Editor of the Wall Street Journal.

FDA Warning Label Letter to the Editor

That antidepressant medications are recommended for warning labels by the FDA because of their potential for increasing suicide risk misses the point; the warning label needs to be put on the practitioner, not the pill.

With few exceptions, the American healthcare industry is under-trained and generally incompetent to detect and assess suicide risk in the patients for whom they prescribe these otherwise helpful agents. Writing a prescription for an antidepressant for an already suicidal patient is a national problem, and especially among our older citizens. Among the findings published in the 2002 Institute of Medicine (IOM) report, Reducing Suicide, a National Imperative, are the following:

Most People who complete suicide had contact with a health professional within a year of death, and 40 percent of these contacts were within one month of their death. Many people die by overdose on the prescription medications provided them at these visits.
Screening for depression, substance abuse and suicide potential is not routine in primary care, even though primary care providers are often the 'first and only medical contact" suicidal patients have with the healthcare system. As a result, suicide risk is not detected.
Primary care physicians lack training and evidence-based screening, assessment, and referral practices for suicidality.

Before we frighten the people who need these potentially life-saving medications away from their proper use under competent medical supervision, perhaps we should require non-psychiatric healthcare providers to learn something about how to detect, assess and manage those at risk for suicide before reading for their prescription pads. In the matter of suicidal, depressed people the current "Don't ask, Don't tell," don't work.

Paul Quinnett, Ph.D. is the President and CEO of the QPR Institute, a training organization devoted to preventing suicide, and the Editor-in Chief of Preventing Suicide: the National Journal.

SPRING 2004	News! To further address the needs of college students, the QPR Institute has linked up with the National Collegiate Athletic Association (NCAA) to customize and deliver a mental health awareness and QPR suicide prevention training program to key gatekeepers in the lives of student athletes. Thanks to Steve and Jan Ulrick (who lost their son Nathan Eisert, a basketball player at Western Kentucky University) doors have swung open to a suicide prevention program for the 1,200 colleges and universities and the 360,000 student-athlete members of the NCAA. This project includes a partnership with the National Mental Health Association whose educational materials and support will help lend credibility to the important message that mental health matters! Tool kit update: For those wishing to include a message on clinical depression and mood disorders (the leading cause of suicidal behaviors), a series of PowerPoint slides can now be downloaded from the Download Page of the Instructor Area and integrated into your training. The source of this material is the National Institute of Mental Health.
Lot’s of news in this issue, with new resources and program upgrades in the QPR Instructor section. Check them out! Since the beginning of this year 92 additional QPR Instructors have been trained and certified in 11 states. We wish to give a warm welcome to those people trained by the Devereux Foundation, Bluegrass Regional Health Board in Kentucky, the Shoshone-Bannock Tribes from Fort Hall, Idaho, those trained in Salt Lake city and all Instructor's who became Certified through the self-study format. Reminders: The QPR Gatekeeper Training competency quiz is available for you to take (as a sample) in the password protected area for instructors. Online quizzes and CEU credits are now available for both Counseling Suicidal People and Suicide the Forever decision under Certificates and Quizzes
QPR is headed to college. According to the Surgeon General: Young adults aged 18-24 have the highest incidence of reported suicide ideation One fourth of all persons aged 18-24 years in the U.S. are either full- or part-time college or university students A large proportion of this at-risk population could be reached through campus-based suicide prevention efforts According to the National Mental Health Association, “suicide is the second leading cause of death among college-age students, with an estimated 1,088 occurring on campuses each year. M.I.T. and other universities have contended with lawsuits related to on-campus suicides and the services these institutions provide to students at risk.” In a study by the Centers for Disease Control published in the Journal of Consulting and Clinical Psychology 1995, 10% of college students admitted to having suicidal thoughts during the 12 months preceding the survey. These students came from both two- and four-year public and private colleges and universities. Seven percent said they had made a suicide plan, 2% had attempted suicide at least once, and 0.4% had made a suicide attempt that required medical attention. The cost to the economy of a young life lost to suicide is estimated to be approximately one million dollars; the emotional costs to surviving family members, students, staff and faculty are incalculable. As you will recall from a recent news release, Eastern Washington University School of Social Work and Human Services and the QPR Institute now enjoy a partnership which enables both organization to serve the public good by offering college credit courses in suicide risk assessment and risk management for those in the helping professions. The online courses are now available for both CEUs and college credit.
As QPR Instructors you may be asked by those in your audiences about the new FDA recommended warning label to be placed on antidepressant medications, especially as regards the supposed link between taking the medication and increased suicidal thoughts, feelings and behaviors. While you may have your own thoughts about what this announcement means, Dr. Quinnett responded with the following Letter to the Editor of the Wall Street Journal. FDA Warning Label Letter to the Editor That antidepressant medications are recommended for warning labels by the FDA because of their potential for increasing suicide risk misses the point; the warning label needs to be put on the practitioner, not the pill. With few exceptions, the American healthcare industry is under-trained and generally incompetent to detect and assess suicide risk in the patients for whom they prescribe these otherwise helpful agents. Writing a prescription for an antidepressant for an already suicidal patient is a national problem, and especially among our older citizens. Among the findings published in the 2002 Institute of Medicine (IOM) report, Reducing Suicide, a National Imperative, are the following: Most People who complete suicide had contact with a health professional within a year of death, and 40 percent of these contacts were within one month of their death. Many people die by overdose on the prescription medications provided them at these visits. Screening for depression, substance abuse and suicide potential is not routine in primary care, even though primary care providers are often the 'first and only medical contact" suicidal patients have with the healthcare system. As a result, suicide risk is not detected. Primary care physicians lack training and evidence-based screening, assessment, and referral practices for suicidality. Before we frighten the people who need these potentially life-saving medications away from their proper use under competent medical supervision, perhaps we should require non-psychiatric healthcare providers to learn something about how to detect, assess and manage those at risk for suicide before reading for their prescription pads. In the matter of suicidal, depressed people the current "Don't ask, Don't tell," don't work. Paul Quinnett, Ph.D. is the President and CEO of the QPR Institute, a training organization devoted to preventing suicide, and the Editor-in Chief of Preventing Suicide: the National Journal.
New listserv for youth suicide prevention: I am launching a new listserv for youth suicide prevention and inviting you to join. I am very excited about the potential this has for increasing our knowledge of and connections to prevention efforts going on in the Northwest! The listserv, YSP Network, is intended to encourage discussion, networking, problem solving and resource sharing among and across the many disciplines of people who are interested in preventing youth suicide. Interested? I hope so! To Join and/or to get more information, go to YSP Network and follow the instructions to sign up. Please invite your colleagues and others who are involved in youth suicide prevention to join YP Network. The more interested people who are involved, the better resource it will become! Feel free to contact me. Donna G Noonan, MPH, CHES Youth Suicide Prevention Coordinator Injury Prevention & Epidemiology Program Phone: 503-872-5332 or donna.noonan@state.or.us www.dhs.state.or.us/publichealth/ipe.suicide.cfm